How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Facility | None | $52.48 | $52.48 | $52.48 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $54.95 | Professional | None | $52.48 | $52.48 | $54.95 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $147.91 Typical High $169.82 | Facility | None | $120.23 | $147.91 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $89.13 Typical High $112.20 | Professional | None | $63.10 | $89.13 | $112.20 |
Medica Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $1,148.15 | Facility | None | $89.13 | $89.13 | $1,148.15 |
Medica Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $1,288.25 | Professional | None | $52.48 | $52.48 | $1,288.25 |
Midlands Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | None | $63.10 | $63.10 | $63.10 |
Midlands Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $204.17 | Facility | None | $169.82 | $169.82 | $204.17 |
Sanford Health Plan Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $977.24 | Professional | None | $977.24 | $977.24 | $977.24 |
United Setting Professional Modifier None Typical Low $120.23 Median $125.89 Typical High $141.25 | Professional | None | $120.23 | $125.89 | $141.25 |
Wellmark Setting Facility Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Facility | None | $52.48 | $52.48 | $52.48 |
Wellmark Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | None | $52.48 | $52.48 | $52.48 |
4 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $26.30 Median $26.30 Typical High $27.54 | Professional | 52 · Reduced service | $26.30 | $26.30 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $10.72 Typical High $10.96 | Professional | 53 · Discontinued | $10.72 | $10.72 | $10.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $7.94 Typical High $8.32 | Professional | 55 · Aftercare only | $7.94 | $7.94 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $5.25 Typical High $5.50 | Professional | 56 · Pre-op care only | $5.25 | $5.25 | $5.50 |
Where South Dakota sits
The same service costs 18.6 times more in Wyoming than in Kentucky. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
South Dakota· 46th of 51
$66.07
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.